Tactics and tropes of the antivaccine movement

I’ve been an observer and student of the antivaccine movement for nearly a decade now, although my intensive education began almost seven years ago, in early 2005, not long after I started blogging. It was then that I first encountered several “luminaries” of the antivaccine movement both throughout the blogosphere and sometimes even commenting on my blog itself. I’m talking about “luminaries” such as J.B. Handley, who is the founder of Generation Rescue and was its leader and main spokesperson; that is, until he managed to recruit spokesmodel Jenny McCarthy to be its public face, and Dr. Jay Gordon, who, although he swears to high heaven he is not antivaccine, sure could have fooled me. At the very minimum, “Dr. Jay” is a credulous apologist for the antivaccine movement; at the worst, he is practically a card-carrying member. Then there were many more through the years: Barbara Loe Fisher, Sallie Bernard, various bloggers from the antivaccine crank blog Age of Autism, and even the new generation of antivaccine activists, such as Jake Crosby, who is, if anything, even more annoying than the old generation.

Why am I mentioning this? The reason is simple. Over the years, I think I’ve come to learn just about every antivaccine trope, canard, strategy, and argument there is. At least, I know all the major ones, nearly all of the minor ones, and even quite a few of the obscure ones. As a result, I’m rarely surprised anymore, even when of late antivaccinationists have taken to referring to supporters of science-based medicine as “vaccine injury denialists,” a term antivaccine activist Ginger Taylor notably used in “The Role of Government and Media,” a chapter in the anti-vaccine book Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children, which was edited by Louise Kuo Habakus and Mary Holland. Now, Taylor uses the term frequently on her blog in a hilarious bit of Pee-Wee Herman-like, “I know you are, but what am I?” (That actually might be a topic for another post entirely.) So when I see people writing about the tropes and tactics favored by the antivaccine movement, I know I’m quite qualified to judge whether they know what they’re talking about or not, as I’ve spent nearly a decade in the trenches on Usenet and in the blogosphere.

Anna Kata of McMaster University appears to know what she’s talking about.

Kata is the author of a recent article in Vaccine entitled Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement. Her opening sets the stage:

Vaccinations are a significant public health achievement, contributing to dramatic declines in morbidity and mortality from vaccine-preventable diseases [1]. However, by reading certain websites, one might be persuaded to think the opposite – that vaccines are actually ineffective, useless, or even dangerous. These are merely some of the arguments posed by the anti-vaccination movement, an amorphous group holding diverse views that nevertheless shares one core commonality: an opposition to vaccines. The popularity and pervasiveness of the Internet today has facilitated the transmission of such beliefs.

Many people search online for health information, and the information found impacts patient decision-making; it is therefore essential to understand what is shared online. This paper provides an overview of how the new generation of the Internet (Web 2.0) and its emphasis on user-generated content has combined with characteristics of the current postmodern medical paradigm, creating a new environment for sharing health information. The anti-vaccination movement has taken advantage of this milieu to disseminate its messages.

She immediately launches into a discussion of how Web 2.0 has proven to be a two-edged sword in medicine. While, as I’ve discussed before, paternalism is on the decline and medicine is moving towards a model of shared decision-making between the physician and patient, a process facilitated by the availability of more high quality information about health on the web than has ever been so easily available before, that movement can easily be hijacked by the dark side of Web 2.0. While 20 years ago, medical knowledge was largely bound to textbooks, journals, and medical institutions, today, not only is it available on many websites but even the primary literature is in many cases available to the public, thanks to laws requiring that NIH-funded research be deposited in PubMed Central and that clinical trials and their results be deposited in ClinicalTrials.gov. Unfortunately, the power of the Web 2.0 to empower patients is also the power to confuse and misinform. As Kata points out, postmodern attitudes, in which science-based medicine is just “another way of knowing” can combine with new “expert systems” in which people without advanced training come to think themselves just as much “experts” as the real experts. Although Kata doesn’t mention it, it’s the Dunning-Kruger effect writ large, the arrogance of ignorance.

Kata also correctly identifies most of the common tropes and tactics of the antivaccine movement. First, the tactics:

  1. Skewing the science. This involves cherry picking studies, denigrating science that doesn’t support an antivaccine viewpoint, and endorsing bad science that supports antivaccine agendas.
  2. Shifting hypotheses. Otherwise known as moving the goalposts, this involves continually changing the standards of evidence deemed necessary to convince antivaccinationists of vaccine safety so that they can’t be met and constantly coming up with new causation hypotheses that share only one thing in common: it’s always about the vaccines.
  3. Censorship. This is an extreme characteristic of the antivaccine movement. For instance, Age of Autism does not allow dissenting comments. The Autism One yearly quackfest routinely kicks out those its organizers perceive as enemies, even though they follow the rules and don’t disrupt anything. In the meantime, they go absolutely–if you’ll excuse the term–apeshit when one of their own is asked to leave a scientific function. We’re seeing this in action right now, as AoA and its hanger-on Ginger Taylor are both going nuts over Paul Offit’s and Seth Mnookin’s having asked AoA’s one trick pony irritant to leave and Offit’s accurately characterizing him as a “stalker.” I’d take their complaints slightly more seriously if the antivaccine movement didn’t so ruthlessly censor its perceived enemies and refuse to let them anywhere near their crank venues.
  4. Attacking the opposition. The antivaccine movement is particularly incessant in this tactic, in my experience. I’ve lost track of how many times I’ve been attacked or had antivaccine cranks try to cause me annoyance at my job by e-mailing my bosses. A year and a half ago, a bunch of antivacicne cranks, “inspired” by a false accusation of an undisclosed conflict of interest from Jake Crosby, tried to get me fired from my job through a campaign of e-mails, phone calls, and letters to the board of governors at my university. And what I’ve experienced is minor indeed compared to what someone like Paul Offit has experienced.

One tactic I think Kata left out is one that I’ve noted before. It’s not a tactic unique to the antivaccine movement, but antivaccinationists certainly use it. I’m referring to crank conferences gussied up to look like legitimate scientific conferences. For example, we have the yearly quackfest known as Autism One every year in Chicago around Memorial Day. Recently, Autism One has joined forces with the health freedom movement, combining an Autism One conference with the Health Freedom Expo from March 2-4, 2012 in Long Beach, CA. In this, we might be seeing an even more obvious sign of the scientific bankruptcy of antivaccinationists in that Patrick “Tim” Bolen will be featured on a “Vaccine Panel.” I thought that having Dan Olmsted chair a panel called Malfeasance in the Media that includes Tim Bolen, David Lewis, and Andy Wakefield was bad enough. After all, that’s a group that could give the masters’ how-to-do-it course on media malfeasance.

Oh, and “movie night” is going to feature the Burzynski movie, as well.

Now, here are the tropes:

  1. “I’m not antivaccine; I’m pro-safe vaccines.” Yes, indeed. This one is the biggest, baddest, most irritating trope of all, repeated by everyone from Jenny McCarthy to J.B. Handley to Barbara Loe Fisher. A variant of this is to liken vaccines to cars and say that “I’m not ‘anti-car,’ I just want safer cars.” Not a good analogy. A better equivalent would be if they demanded absolute safety of cars and refused to use them unless GM, Ford, Chrysler, Toyota, Honda, et al swear that they’ll never be injured in a car crash.
  2. Vaccines are toxic. A.k.a. “the toxin gambit.”
  3. A demand for absolute safety.
  4. A demand for absolute “proof” that vaccines are safe.
  5. “Vaccines didn’t save us,” one of the more intellectually dishonest of many intellectually dishonest tropes used by these cranks.
  6. Vaccines are “unnantural.”
  7. Choosing between “vaccine injury” and disease. Jenny did this famously when she said vaccination are a choice between autism and infectious disease and that she’d take the measles.

Kata lists more of these tropes, and this is one case where I can’t think of any that she missed, at least not major ones, except for perhaps the recent coopting of the term “denialism” for their own, as Ginger Taylor does when she uses “vaccine injury denialist” as a trope. Kata also didn’t emphasize the concept of “misinformed consent” enough, in which under the guise of “informed consent” antivaccine pseudoscience is used to make vaccines seem more dangerous and less effective than they actually are.

Kata closes by remembering a famous quote by J.B. Handley, in which he likened Andrew Wakefield to “Nelson Mandela and Jesus Christ all rolled up into one,” after which she concludes:

Such a statement is a reminder that finding common ground with those who question, fear, or crusade against vaccines is no easy task. Their arguments are constantly shifting and evolving – this has been furthered by the fluidity of the Internet and social media. While acknowledging and correcting flawed arguments is important, an approach that moves beyond providing “the facts” is likely needed. With the anti-vaccination movement embracing the postmodern paradigm, which inherently questions an authoritative, science-based approach, “facts” may be reinterpreted as just another “opinion”. This issue is as much about the cultural context surrounding healthcare, perceptions of risk, and trust in expertise, as it is about vaccines themselves. For these reasons it is possible the minds of deeply invested anti-vaccine activists may never be changed; therefore it is for both the laypersons with genuine questions or worries about vaccines and the healthcare professionals who work to ease their fears that keeping abreast of the methods of persuasion discussed here is essential. Recognizing anti-vaccine tactics and tropes is imperative, for an awareness of the disingenuous arguments used to cajole and convert audiences gives individuals the tools to think critically about the information they encounter online. It is through such recognition that truly informed choices can then be made.

If there’s one thing I’ve tried to do on this blog, it’s to hammer away at each and every one of these common anti-vaccine tropes, as well as the not-so-common ones as well. The reason is that I don’t want them to be able to spread these tropes unopposed and unanswered, although the antivaccine movement is so protean and I have a day job that it seems like a Sisyphean task in which progress appears minimal. Yet the skeptic movement and physicians like Paul Offit appear to have had some effect, particularly in the wake of Andrew Wakefield’s downfall. At least anecdotally, I see less antivaccine propaganda making it into mainstream media reports, less blatant false “balance,” in which antivaccine propagandists are given equal voice with scientists as though there were two equivalent sides to the argument, and more skeptical articles that refute antivacicne myths and expose antivaccine autism quacks. Kata is right. The basis for such progress is the wide dissemination of good science about vaccines, refutation of the misinformation spread about vaccines, and shining the light of day on the various quacks who take advantage of the antivaccine movement. It’s not enough in and of itself, but it’s a start.